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Idnay B, Cordoba E, Ramirez SO, Xiao E, Wood OR, Batey DS, Garofalo R, Schnall R. Social Marketing Perspective on Participant Recruitment in Informatics-Based Intervention Studies. AIDS Behav 2024:10.1007/s10461-024-04355-6. [PMID: 38703337 DOI: 10.1007/s10461-024-04355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
Effective recruitment strategies are pivotal for informatics-based intervention trials success, particularly for people living with HIV (PLWH), where engagement can be challenging. Although informatics interventions are recognized for improving health outcomes, the effectiveness of their recruitment strategies remains unclear. We investigated the application of a social marketing framework in navigating the nuances of recruitment for informatics-based intervention trials for PLWH by examining participant experiences and perceptions. We used qualitative descriptive methodology to conduct semi-structured interviews with 90 research participants from four informatics-based intervention trials. Directed inductive and deductive content analyses were guided by Howcutt et al.'s social marketing framework on applying the decision-making process to research recruitment. The majority were male (86.7%), living in the Northeast United States (56%), and identified as Black (32%) or White (32%). Most participants (60%) completed the interview remotely. Sixteen subthemes emerged from five themes: motivation, perception, attitude formation, integration, and learning. Findings from our interview data suggest that concepts from Howcutt et al.'s framework informed participants' decisions to participate in an informatics-based intervention trial. We found that the participants' perceptions of trust in the research process were integral to the participants across the four trials. However, the recruitment approach and communication medium preferences varied between older and younger age groups. Social marketing framework can provide insight into improving the research recruitment process. Future work should delve into the complex interplay between the type of informatics-based interventions, trust in the research process, and communication preferences, and how these factors collectively influence participants' willingness to engage.
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Affiliation(s)
- Betina Idnay
- School of Nursing, Columbia University, New York, NY, USA.
- Department of Biomedical Informatics, Columbia University, New York, NY, USA.
| | - Evette Cordoba
- School of Nursing, Columbia University, New York, NY, USA
| | | | - Eugenia Xiao
- School of Nursing, Columbia University, New York, NY, USA
| | - Olivia R Wood
- School of Nursing, Columbia University, New York, NY, USA
| | - D Scott Batey
- School of Social Work, Tulane University, New Orleans, LA, USA
| | - Robert Garofalo
- Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine Northwestern University, Chicago, IL, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, NY, USA
- Mailman School of Public Health, Columbia University, New York, NY, USA
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Weeden T, Garofalo R, Johnson AK, Schnall R, Cervantes M, Scherr T, Kuhns LM. Assessing Preferences for Long-Acting Injectable Pre-Exposure Prophylaxis Among Young Adult Sexual Minority Men and Transgender Women. Acad Pediatr 2024:S1876-2859(24)00148-7. [PMID: 38631476 DOI: 10.1016/j.acap.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, oral PrEP uptake is low, particularly among sexual and gender minority youth who are vulnerable to HIV infection. Alternative methods of PrEP delivery, such as long-acting injectable (LAI) PrEP may overcome barriers and be preferred. However, attitudes and preferences of younger sexual and gender minorities towards LAI PrEP have not been well studied. The purpose of this study is to describe preferences for initiating LAI PrEP among sexual and gender minority youth. METHODS We analyzed data collected as part of an HIV prevention randomized trial from January 2022 to February 2023, using multiple regression to identify factors associated with a preference for LAI PrEP. RESULTS The study sample (N = 265) was 50% youth of color, mean age 25 years (SD=3.4, range=18-31), and primarily identified as gay (71%) and male (91%). Forty two percent had heard of LAI PrEP and 31% preferred LAI PrEP over other prevention methods. In multiple regression analysis, LAI PrEP preference was associated with identifying as White, previous PrEP experience, and perceived LAI PrEP efficacy. CONCLUSIONS We conclude that gaps in awareness exist for LAI PrEP, however it may be preferred over other prevention methods especially in White youth, those with PrEP experience and higher perceptions of its efficacy. More education and outreach are needed to prevent extension of existing race and ethnicity disparities in use of oral daily PrEP to LAI PrEP.
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Affiliation(s)
- Terrance Weeden
- Northwestern University (T Weeden, R Garofalo, AK Johnson, and LM Kuhns), Department of Pediatrics, Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago (T Weeden, R Garofalo, AK Johnson, M Cervantes, and LM Kuhns), Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Ill
| | - Robert Garofalo
- Northwestern University (T Weeden, R Garofalo, AK Johnson, and LM Kuhns), Department of Pediatrics, Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago (T Weeden, R Garofalo, AK Johnson, M Cervantes, and LM Kuhns), Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Ill
| | - Amy K Johnson
- Northwestern University (T Weeden, R Garofalo, AK Johnson, and LM Kuhns), Department of Pediatrics, Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago (T Weeden, R Garofalo, AK Johnson, M Cervantes, and LM Kuhns), Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Ill
| | - Rebecca Schnall
- School of Nursing (R Schnall), Columbia University, New York City, NY
| | - Marbella Cervantes
- Ann & Robert H. Lurie Children's Hospital of Chicago (T Weeden, R Garofalo, AK Johnson, M Cervantes, and LM Kuhns), Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Ill
| | - Thomas Scherr
- Department of Chemistry (T Scherr), Vanderbilt University, Nashville, Tenn
| | - Lisa M Kuhns
- Northwestern University (T Weeden, R Garofalo, AK Johnson, and LM Kuhns), Department of Pediatrics, Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago (T Weeden, R Garofalo, AK Johnson, M Cervantes, and LM Kuhns), Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Ill.
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Peng ML, Wickersham JA, Altice FL, Shrestha R, Azwa I, Zhou X, Halim MAA, Ikhtiaruddin WM, Tee V, Kamarulzaman A, Ni Z. Formative Evaluation of the Acceptance of HIV Prevention Artificial Intelligence Chatbots By Men Who Have Sex With Men in Malaysia: Focus Group Study. JMIR Form Res 2022; 6:e42055. [PMID: 36201390 PMCID: PMC9585446 DOI: 10.2196/42055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Mobile technologies are being increasingly developed to support the practice of medicine, nursing, and public health, including HIV testing and prevention. Chatbots using artificial intelligence (AI) are novel mobile health strategies that can promote HIV testing and prevention among men who have sex with men (MSM) in Malaysia, a hard-to-reach population at elevated risk of HIV, yet little is known about the features that are important to this key population. OBJECTIVE The aim of this study was to identify the barriers to and facilitators of Malaysian MSM's acceptance of an AI chatbot designed to assist in HIV testing and prevention in relation to its perceived benefits, limitations, and preferred features among potential users. METHODS We conducted 5 structured web-based focus group interviews with 31 MSM in Malaysia between July 2021 and September 2021. The interviews were first recorded, transcribed, coded, and thematically analyzed using NVivo (version 9; QSR International). Subsequently, the unified theory of acceptance and use of technology was used to guide data analysis to map emerging themes related to the barriers to and facilitators of chatbot acceptance onto its 4 domains: performance expectancy, effort expectancy, facilitating conditions, and social influence. RESULTS Multiple barriers and facilitators influencing MSM's acceptance of an AI chatbot were identified for each domain. Performance expectancy (ie, the perceived usefulness of the AI chatbot) was influenced by MSM's concerns about the AI chatbot's ability to deliver accurate information, its effectiveness in information dissemination and problem-solving, and its ability to provide emotional support and raise health awareness. Convenience, cost, and technical errors influenced the AI chatbot's effort expectancy (ie, the perceived ease of use). Efficient linkage to health care professionals and HIV self-testing was reported as a facilitating condition of MSM's receptiveness to using an AI chatbot to access HIV testing. Participants stated that social influence (ie, sociopolitical climate) factors influencing the acceptance of mobile technology that addressed HIV in Malaysia included privacy concerns, pervasive stigma against homosexuality, and the criminalization of same-sex sexual behaviors. Key design strategies that could enhance MSM's acceptance of an HIV prevention AI chatbot included an anonymous user setting; embedding the chatbot in MSM-friendly web-based platforms; and providing user-guiding questions and options related to HIV testing, prevention, and treatment. CONCLUSIONS This study provides important insights into key features and potential implementation strategies central to designing an AI chatbot as a culturally sensitive digital health tool to prevent stigmatized health conditions in vulnerable and systematically marginalized populations. Such features not only are crucial to designing effective user-centered and culturally situated mobile health interventions for MSM in Malaysia but also illuminate the importance of incorporating social stigma considerations into health technology implementation strategies.
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Affiliation(s)
- Mary L Peng
- Social and Behavioral Sciences Department, Yale School of Public Health, New Haven, CT, United States
| | - Jeffrey A Wickersham
- Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, CT, United States
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Frederick L Altice
- Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, CT, United States
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Division of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Roman Shrestha
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, CT, United States
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Iskandar Azwa
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Infectious Disease Unit, Faculty of Medicine, Kuala Lumpur, Malaysia
| | - Xin Zhou
- Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Mohd Akbar Ab Halim
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Mohd Ikhtiaruddin
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vincent Tee
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adeeba Kamarulzaman
- Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Infectious Disease Unit, Faculty of Medicine, Kuala Lumpur, Malaysia
| | - Zhao Ni
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, CT, United States
- School of Nursing, Yale University, New Haven, CT, United States
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Budzyńska J, Patryn R, Kozioł I, Leśniewska M, Kopystecka A, Skubel T. Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159331. [PMID: 35954695 PMCID: PMC9368376 DOI: 10.3390/ijerph19159331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023]
Abstract
So far, the rate of HIV-positive people who do not know their sero-status is about 14% and the percentage is higher among transgender women (TGW). They represent one of the most vulnerable groups to infection. HIV self-testing (HIVST) may be a way to reduce transmission of the virus. The aim of this analysis and in-depth review was to collect available data on factors that may influence the use and dissemination of HIVST among TGW. This review was conducted in accordance with PRISMA guidelines for systematic reviews and meta-analyses. All data from 48 papers were used. From the available literature, HIVST is a convenient and preferred method of testing due to its high confidentiality and possibility of being performed at home. However, there are barriers that limit its use, including marginalization of transgender people, stigma by medical personnel, lack of acceptance of sexual partners, and even cultural standards. Therefore, there is a need for activities that promote and inform on the possibility of using HIVST as well as enable easier access to it.
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Affiliation(s)
- Julia Budzyńska
- Students’ Scientific Group on Medical Law, Department of Humanities and Social Medicine, Medical University of Lublin, 20-059 Lublin, Poland; (I.K.); (M.L.); (A.K.); (T.S.)
- Correspondence:
| | - Rafał Patryn
- Department of Humanities and Social Medicine, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Ilona Kozioł
- Students’ Scientific Group on Medical Law, Department of Humanities and Social Medicine, Medical University of Lublin, 20-059 Lublin, Poland; (I.K.); (M.L.); (A.K.); (T.S.)
| | - Magdalena Leśniewska
- Students’ Scientific Group on Medical Law, Department of Humanities and Social Medicine, Medical University of Lublin, 20-059 Lublin, Poland; (I.K.); (M.L.); (A.K.); (T.S.)
| | - Agnieszka Kopystecka
- Students’ Scientific Group on Medical Law, Department of Humanities and Social Medicine, Medical University of Lublin, 20-059 Lublin, Poland; (I.K.); (M.L.); (A.K.); (T.S.)
| | - Tomasz Skubel
- Students’ Scientific Group on Medical Law, Department of Humanities and Social Medicine, Medical University of Lublin, 20-059 Lublin, Poland; (I.K.); (M.L.); (A.K.); (T.S.)
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